Diabetes, Metabolic Syndrome and Obesity (Aug 2021)

Assessment of Microcirculation in the Type 2 Diabetic and Impaired Glucose Tolerance Feet of Elderly Men by CEUS

  • Li X,
  • Wu L,
  • Yang Z,
  • Hu Y,
  • Zhou C,
  • Ji R

Journal volume & issue
Vol. Volume 14
pp. 3647 – 3652

Abstract

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Xiaoyu Li,1,* Lin Wu,2,* Zhifang Yang,1 Yunyun Hu,1 Chun Zhou,1 Ri Ji1 1Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 2Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chun Zhou; Ri JiDepartment of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of ChinaTel/Fax +86 021 63846590; Tel +86 18717771587Email [email protected]; [email protected]: To evaluate the foot microcirculation in type 2 diabetes mellitus (T2DM) and impaired glucose tolerance patients (IGT) with contrast-enhanced ultrasound (CEUS).Methods: The study included 37 patients with T2DM but without diabetic foot (DM group), 15 patients with impaired glucose tolerance (IGT group) and 10 elderly males with normal fasting blood glucose (FBS) and negative glucose tolerance tests (control group). Color Doppler flow imaging (CDFI) and CEUS were performed on the right foot great toes for detecting the blood perfusion performance. CEUS images were recorded and parameters of CDFI and flow time-intensity curves (TICs) were analyzed by the Student’s t-test.Results: There was no significant difference in CDFI parameters pulse index and peak systolic blood flow velocity (PSV) among the three groups (P > 0.05). Compared with control group, CEUS images of IGT and DM groups showed lower microvascular density and were pale. Peak intensity (PI) and area under time-intensity curve (AUC) in control, IGT and DM groups were decreased gradually (PI 46.36± 10.96 vs 35.26± 11.65 vs 28.15± 7.94, P = 0.001, AUC 5.12± 1.02 vs 3.25± 1.60 vs 2.81± 1.20, P = 0.001). The arrival times (AT) and time to peak (TTP) tended to be increased with the extension of DM course, but the difference was not statistically significant (AT, P = 0.260, TTP, P = 0.481).Conclusion: CEUS, as a noninvasive and valuable technique, could detect the alterations in foot microcirculation of DM and IGT patients.Keywords: type 2 diabetes mellitus, impaired glucose tolerance, contrast-enhanced ultrasound, microcirculation

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